Facetectomies involve decompression of the spinal nerve root by removal of a spinal facet or a part thereof. Facetectomy surgeries are often performed to treat orthopedic conditions, such as spondylolisthesis, cervical rhizalgia, and nerve root compression due to facet joint degeneration. Current surgical tools used to perform facetectomies include osteotomes, which are driven into the bone by manual or mechanical means at the surgical site to excise a spinal facet or part thereof. A drawback to current osteotomes is the risk of nerve damage due to the possibility that the osteotome will inadvertently advance too deeply past the bone into the spinal canal, potentially damaging vital structures such as the spinal cord.
Additionally, some current surgical tools require multiple steps to remove the bone, and do not remove a sufficient amount of bone in a single step. For example, rounded gauges may perform a semicircular in the bone facet, but such tools do not prevent inadvertent entrance into the neural canal or other vital structures. They also do not remove as much of the facet joint as two cuts from a standard osteotome or one cut from a 90° osteotome. Likewise, power burrs are power instruments (e.g., Midas Rex M-8) used to remove facet joints but these instruments do not prevent inadvertent entrance into the neural canal or other critical areas. Using a power burr requires more time, can cause more bleeding, and/or is more difficult to define and preserve the remaining superior facet compared to osteotomes. Preserving the remaining superior facet is important, as this serves as a landmark for placement of surgical devices, such as pedicle screws.
There is a need in the art for an improved surgical device that allows safer, more controlled bone excision, prevents accidental entrance into vital areas around the excision site, does not require multiple steps to remove bone, and removes a sufficient amount of bone in one step.